Active NPI
Ebony Gourrier, LCSW
- Social Worker
- Shreveport, LA
National Provider Identifier
1023475548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 13875
- Practice address
- 3004 Knight St Ste 149
Shreveport, LA 71105-2502 - Phone
- (318) 553-5082
- NPI assigned
- Jan 28, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | 13875 | LA | |
| Case Manager/Care Coordinator | 171M00000X | |||
| Social Worker | 104100000X | 13875 | LA | Primary |
Addresses
Primary practice location
3004 Knight St Ste 149
Shreveport, LA 71105-2502
Mailing address
2ND Medical Group
Barksdale Afb, LA 71110
Phone (318) 456-6600
Other practice location 1
2nd Medical Group
Barksdale AFB, LA 71110
Phone (318) 456-6600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13875 | LA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715212800000",
"number": "1023475548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2ND MEDICAL GROUP",
"city": "BARKSDALE AFB",
"state": "LA",
"postal_code": "71110",
"telephone_number": "318-456-6600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3004 KNIGHT ST STE 149",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711052502",
"telephone_number": "318-553-5082"
}
],
"practiceLocations": [
{
"address_1": "2nd Medical Group",
"address_purpose": "LOCATION",
"city": "Barksdale AFB",
"state": "LA",
"postal_code": "71110",
"country_code": "US",
"telephone_number": "318-456-6600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOURRIER",
"first_name": "EBONY",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-28",
"last_updated": "2024-05-09",
"certification_date": "2024-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "LA",
"license": "13875",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "LA",
"license": "13875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.